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Wisconsin Department of Commerce SOIL EVALUATION REPORT Page_�of_ <br /> Division of Safety and Buildings <br /> in accordance with Comm 85,Wis. Adm. Code T <br /> BG/t ` <br /> Attach complete site plan on paper not less than 6 1/2 x 11 inches In size.Plan must County �j G <br /> Include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I D <br /> percent slope,scale or dimensions,north arrow,and location and distance to nearest road. X 2X 0 .2 16611 <br /> Please print ad Information. Reviewed by Dat <br /> Personal information you provide may be used for secondary purposes(Privacy Law,a.15.04(1)(m)). 90 <br /> Mnxer Property Location <br /> A) e-.171 / �z Govt Lot IVA) 1/4 4A14 SrZ V T5/U N R/.I— E(or) <br /> Property Min es Mailing AddressLot# Block# Subd.Name or CSM# <br /> City State Zip Code Ptane Nwrtw ❑City ❑Vil <br /> lege Town Nearest Road C.a ,- <br /> 6 1t 75iG�Sc�n/ . <br /> ❑ New Construction Use:�Resldential/Number of bedrooms_2 _ Code derived design flow rate GPD <br /> f gReplatom ent // ❑ Public or com ercial- scribe: <br /> Parent material al'4 C!/F �r-/�� _ Flood Plain elevation if applicable <br /> General comments +1 <br /> and recommendations: <br /> 171 Boring# 0 Boring <br /> -Pit Ground surface elev.�S d ft. Depth to limiting factor-�in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM <br /> in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. •Eff#1 •Eff#2 <br /> ng <br /> ® Boring# K Pit Ground surface elev. a R. Depth to limiting factot>?p in. <br /> Soil Application Rate <br /> Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF <br /> In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Efl#2 <br /> C) ,.s �P cs <br /> �7 d1� .Z <br /> Effluent#1=BOD >30:S 220 mglL and TSS>30 1150 mgA. •Effluent#2=BOD 130 mg&and TSS 130 mg& <br /> CST <br /> Adm Date Evaluation Conducted Telephone Number, <br />